Effects of Gestational and Postnatal Age on Body Temperature, Oxygen Consumption, and Activity during Early Skin-to-Skin Contact between Preterm Infants of 25-30-Week Gestation and Their Mothers

Abstract

Temporary skin-to-skin contact between preterm infant and the mother is increasingly used in neonatal medicine to promote bonding. It is not known at which gestational age (GA) and postnatal age skin-to-skin contact outside the incubator is a sufficiently warm environment and is tolerated by preterm infants without a decrease in body temperature, oxygen consumption (VO2) increase, or unrest. We conducted a prospective clinical study of 27 spontaneously breathing preterm infants of 25-30-wk GA. Rectal temperature (Trecta), VO2 (indirect calorimetry), and activity were continuously measured in the incubator (60 min), during skin-to-skin contact (60 min), and back in the incubator (60 min) in wk 1 and 2 of life. In wk 1 the change in Trectal during skin-to-skin contact was related to GA (r=0.585, p=0.0027): infants of 25-27-wk GA lost heat during skin-to-skin contact, whereas infants of 28-30 wk gained heat and their mean Trectal during skin-to-skin contact was 0.3 degrees C higher than before (p < 0.01). No significant changes of VO2 or activity occurred. In wk 2 the infants' VO2 was higher than in wk 1, but VO2 during skin-to-skin contact was the same as in the incubator. Only small fluctuations in Trectal occurred. In wk 2 all infants slept more during skin-to-skin contact than in the incubator (p < 0.02). We conclude that, for preterm infants of 28-30-wk GA, skin-to-skin contact was a sufficiently warm environment as early as postnatal wk 1. For infants of 25-27-wk GA skin-to-skin contact should be postponed until wk 2 of life, when their body temperature remains stable and they are more quiet during skin-to-skin contact than in the incubator.

Respostas fisiológicas de recém-nascidos pré-termo submetidos ao Metódo Mãe-Canguru e a posição prona

“…Do mesmo modo, no estudo de Bauer et al 15 , onde foram avaliados 27 RNPT, entre 25-30 semanas, respirando espontaneamente, observou-se maior duração de sono durante o MMC, quando comparado ao grupo controle: 90% do tempo para os de idade gestacional entre 25-27 semanas e 97% para os de idade gestacional entre 28-30 semanas.…”

Método Mãe Canguru: aplicação no Brasil, evidências científicas e impacto sobre o aleitamento materno

“…11,12,[53][54][55][56] The presence of parents facilitates skinto-skin contact, which, in its turn, allows tactile proprioceptive stimulation and protects against an overload of aversive stimuli, being an acceptable method for the proper stimulation of the babys neurobehavioral development. 55 Preterm babies submitted to skin-to-skin contact showed a better mental development and better results in motor tests, 56 a significantly lower difference in the duration of crying and in the consolability pattern 57 and longer sleep periods.…”

Impact of Skin to Skin Care, Prone and Supine Positioning on Cardiorespiratory Parameters and Thermoregulation in Premature Infants

“…3 d). Other groups, comparing PP with SSC, specified a significant rise from 0.2 to 0.4 ° C [3,27] during SSC. Their measuring cycle was between 3 [27] and 6 h [3] , and the patients were kept in the incubator at thermoneutrality during PP, like we did.…”